Medicine and Health Sciences Commons^™

Social Determinants Of Health And Disease Working Together, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Outcome In Schizophrenia: The Long-Term Good Outcome In Schizophrenia Is Not Yet Good Enough, Amresh Srivastava, Meghan Thakar

Amresh Srivastava

The illness of schizophrenia has always been a matter of concern for its nature and extent of outcome particularly for its regional and cultural differences. The concept of outcome has been evolving and this study examines the scenario of good outcome in developing countries.

Brain, Mind And Behaviour - Emerging Biological Connections, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Baseline Serum Prolactinin Drug Naïve First Episode Schizophrenia Predicts A Positive Clinical And Social Outcome At Five Years, Post Discharge Follow-Up, Amresh Srivastava, Manoj Tamhane, Meghana Thakar, Yves Bureau, Nilesh Shah

Amresh Srivastava

Serum prolactinis an indicator of tuberoinfundibulardopamine activity. It is reported to increase in wide variety of mental illnesses. It has close relationship with antipsychotic therapy. However, its relationship with psychopathology and outcome is not clear. Serum prolactinlevel was measured in 30 male and 30 female drug naive patients of schizophrenia. Subsequently, these patients were treated with antipsychotics. The severity of psychopathology at the baseline and subsequent improvement at the end of 3 weeks and 6 weeks was assessed on modified brief psychiatric rating scale (mBPRS). Available to follow up at five years 18 males & 22 females patients were reassessed …

Perspectives In Social Outcome Of Schizophrenia, Amresh Shrivastava

Amresh Srivastava

No abstract provided.

Challenge, Tension And Possibility: An Exploration Into Contemporary Western Herbal Medicine In Australia, Sue Evans

Dr Sue Evans

This thesis is about the contemporary challenges facing herbal medicine. Specifically it concerns the difficulties faced by Australian herbalists in their attempts to maintain authority over the knowledge base of their craft and a connection with traditional understandings of the uses of plant medicines, while at the same time engaging with biomedicine and the broader Australian healthcare system. It contributes to the study of the nascent field of qualitative studies in contemporary western herbal medicine by making three main arguments. Firstly, Australian herbal medicine is characterised by its origins as a European colonial practice and its history of professional marginalisation …

The Management Of Thymoma: A Systematic Review And Practice Guideline, Conrad Falkson, Andrea Bezjak, Gail Darling, Richard Gregg, Richard Malthaner, Donna Maziak, Edward Yu, Christopher Smith, Sheila Mcnair, Yee Ung, William Evans

Edward Yu

INTRODUCTION: Thymoma is a rare tumor for which there is little randomized evidence to guide treatment. Because of the lack of high-quality evidence, a formal consensus-based approach was used to develop recommendations on treatment. METHODS: A systematic refview of the literature was performed. Recommendations were formed from available evidence and developed through a two-round modified Delphi consensus approach. RESULTS: The treatment recommendations are summarized as follows: Stage I--complete resection of the entire thymus without neoadjuvant or adjuvant therapy. Stage II--complete resection of the entire thymus with consideration of adjuvant radiation for high-risk tumors. Stage IIIA--surgery either initially or after neoadjuvant …

Prescribing Practices Of Clozapine In India: Results Of A Opinion Survey Of Psychiatrists, Amresh Shrivastava, Nilesh Shah

Amresh Srivastava

No abstract provided.

Reviewing Ethiopia’S Health System Development, Richard Wamai

Richard G. Wamai

A country in the horn of Africa region and one of the oldest states, Ethiopia has poor health outcomes even by sub-Saharan Africa’s standards characterized by many decades without a national health policy, weak healthcare system infrastructure and low government spending. Crucially, Ethiopia has taken critical steps in policy and programs to improving the country’s health status. Nevertheless, a World Bank study simulating different scenarios to meet the United Nations Millennium Development Goals (MDGs) on health in the country shows that unprecedented levels of aid flow would be needed. This paper overviews key health measures of Ethiopia and discusses some …

Silence, Power And Communication In The Operating Room, Fauzia Gardezi, Lorelei Lingard, Sherry Espin, Sarah Whyte, Beverley Orser, G. Baker

Lorelei Lingard

Aim.  This paper is a report of a study conducted to explore whether a 1- to 3-minute preoperative interprofessional team briefing with a structured checklist was an effective way to support communication in the operating room.

Background.  Previous research suggests that nurses often feel constrained in their ability to communicate with physicians. Previous research on silence and power suggests that silence is not only a reflection of powerlessness or passivity, and that silence and speech are not opposites, but closely interrelated.

Methods.  We conducted a retrospective study of silences observed in communication between nurses and surgeons in a multi-site observational …

'It's A Cultural Expectation...' The Pressure On Medical Trainees To Work Independently In Clinical Practice, Tara Kennedy, Glenn Regehr, G. Baker, Lorelei Lingard

Lorelei Lingard

CONTEXT: Medical trainees demonstrate a reluctance to ask for help unless they believe it is absolutely necessary, a situation which could impact on the safety of patients. This study aimed to develop a theoretical exploration of the pressure on medical trainees to be independent and to generate theory-based approaches to the implications for patient safety of this pressure towards independent working.

METHODS: In Phase 1, 88 teaching team members from internal and emergency medicine were observed during clinical activities (216 hours), and 65 participants completed brief interviews. In Phase 2, 36 in-depth interviews were conducted using video vignettes. Data collection …

Routine And Adaptive Expert Strategies For Resolving Ict Mediated Communication Problems In The Team Setting, Lara Varpio, Catherine F Schryer, Lorelei Lingard

Lorelei Lingard

CONTEXT: The use of information and communication technologies (ICTs) for supporting interprofessional communication is becoming increasingly common in health care. However, little research has explored how ICTs affect interprofessional communication, or how novices are trained to be effective interprofessional ICT users. This study explores the interprofessional communication strategies of nurses and doctors (trainees and experts) when their communications were mediated by a specific ICT: an electronic patient record (EPR).

METHODS: A total of 72 doctors and nurses participated in this 8-month study on a paediatric in-patient ward. Eighty hours of non-participant observations and 20 semi-structured interviews were conducted. All data …

What's So Great About Rehabilitation Teams? An Ethnographic Study Of Interprofessional Collaboration In A Rehabilitation Unit, Lynne Sinclair, Lorelei Lingard, Ravindra Mohabeer

Lorelei Lingard

OBJECTIVE: To explore team structures, team relationships, and organizational culture constituting interprofessional collaboration (IPC) in a particular rehabilitation setting; to develop a description of IPC practice that may be translated, adapted, and operationalized in other clinical environments.

DESIGN: An ethnographic study involving: Field observations: 40 hours, over 4 weeks, daily activities, 7 interprofessional meetings, 3 care planning meetings, 1 business meeting, and 3 family meetings; Individual observations: a physiotherapist, an occupational therapist, and a social worker individually observed for 45 minutes to an hour; and Interviews: 19 participants, 11 professions, 27 informal, 5 formal interviews. Data analysis consisted of an …

Communication Channels In General Internal Medicine: A Description Of Baseline Patterns For Improved Interprofessional Collaboration, Lesley Gotlib Conn, Lorelei Lingard, Scott Reeves, Karen-Lee Miller, Ann Russell, Merrick Zwarenstein

Lorelei Lingard

General internal medicine (GIM) is a communicatively complex specialty because of its diverse patient population and the number and diversity of health care providers working on a medicine ward. Effective interprofessional communication in such information-intensive environments is critical to achieving optimal patient care. Few empirical studies have explored the ways in which health professionals exchange patient information and the implications of their chosen communication forms. In this article, we report on an ethnographic study of health professionals' communication in two GIM wards through the lens of communication genre theory. We categorize and explore communication in GIM into two genre sets-synchronous …

The Trial Of The Expert Witness: Negotiating Credibility In Child Abuse Correspondence, Catherine Schryer, Elena Afros, Marcellina Mian, Marlee Spafford, Lorelei Lingard

Lorelei Lingard

This article reports on forensic letters written by physicians specializing in identifying children who have experienced maltreatment. These writers face an extraordinary exigence in that they must provide an opinion as to whether a child has experienced abuse without specifically diagnosing abuse and thus crossing into a legal domain. Their credibility was also at issue because, in this jurisdiction, child abuse identification was not recognized as a medical subspecialty and because the status of expert witnesses is currently being challenged. Through an analysis of 72 forensic letters combined with interview data from six letter writers and five letter readers, we …

Timing Of Surgical Antibiotic Prophylaxis Administration: Complexities Of Analysis, Carrie Cartmill, Lorelei Lingard, Glenn Regehr, Sherry Espin, John Bohnen, Ross Baker, Lorne Rotstein

Lorelei Lingard

BACKGROUND: The timing of prophylactic antibiotic administration is a patient safety outcome that is recurrently tracked and reported. The interpretation of these data has important implications for patient safety practices. However, diverse data collection methods and approaches to analysis impede knowledge building in this field. This paper makes explicit several challenges to quantifying the timing of prophylactic antibiotics that we encountered during a recent study and offers a suggested protocol for resolving these challenges. CHALLENGES: Two clear challenges manifested during the data extraction process: the actual classification of antibiotic timing, and the additional complication of multiple antibiotic regimens with different …

Whether To Get An H1n1 Vaccination Or Not?, Chiehwen Ed Hsu

Chiehwen Ed Hsu

In this interview Dr. Hsu provided public health informatics expertise to answer why or why not to receive H1N1 vaccination.

When Every Drops Counts: The Public Health Impact Of Drought, R. Konkel, Mark Miller, Robert Blake, Valeria Carlson

Steve Konkel

What are the public health effects of drought? What is the role of public health and environmental health in planning for drought? What are the political implications of drought and need for public health to be involved in drought planning? How can we reshape environmental health involvement in drought planning?

The Honeypot Study Protocol: A Randomised Controlled Trial Of Exit Site Application Of Medihoney Antibacterial Wound Gel For The Prevention Of Catheter-Associated Infections In Peritoneal Dialysis Patients, David Johnson, Carolyn Clark, Nicole Isbel, Carmel Hawley, Elaine Beller, Alan Cass, Janak De Zoysa, Steven Mctaggart, Geoffrey Playford, Brenda Rosser, Charles Thompson, Paul Snelling

Elaine Beller

Objectives: The primary objective of this study is to determine whether daily exit-site application of standardized antibacterial honey (Medihoney Antibacterial Wound Gel; Comvita, Te Puke, New Zealand) results in a reduced risk of catheter-associated infections in peritoneal dialysis (PD) patients compared with standard topical mupirocin prophylaxis of nasal staphylococcal carriers.

Design: Multicenter, prospective, open label, randomized controlled trial.

Setting: PD units throughout Australia and New Zealand.

Participants: The study will include both incident and prevalent PD patients (adults and children) for whom informed consent can be provided. Patients will be excluded if they have had (1) a history of psychological …

Using An Innovative Electronic Interface To Develop A Public Health Guidance Document, R. Konkel

Steve Konkel

This is part of a presentation given at the NEHA (National Environmental Health Association) 2009 conference in the Atlanta Enterprise Center June 21-24 in Atlanta Georgia.

The Poor Historian, Jeffrey D. Tiemstra Md

Jeffrey Tiemstra, MD, FAAFP

No abstract provided.

Swine Flu Myths - Experts Debunk Four Common Myths About Swine Flu, Chiehwen Ed Hsu

Chiehwen Ed Hsu

To date, no evidence has been found to link eating or handling pork to contracting swine flu. As the cases of the new swine flu virus continue to rise, so too do the misconceptions about the illness. "By eating pork or handling pork products you won't [contract] H1N1," said Ed Hsu, an associate professor of health informatics at the University of Texas Health Science Center and a contributor to ABC News's OnCall+ Swine Flu site. "There is no scientific evidence or literature or any studies that suggest that one contracts H1N1 virus through eating pork or handling pork products." Additionally, …

Should I Wear A Mask To Protect Myself From The Flu?, Chiehwen Ed Hsu

Chiehwen Ed Hsu

It depends. If you already have H1N1 virus infection, you are recommended to wear a mask just to prevent yourself from spreading the virus to others.

Can One Get H1n1 Flu (Swine Flu) From Eating Pork?, Chiehwen Ed Hsu

Chiehwen Ed Hsu

there is no literature (study) suggesting that human being would get swine flu by eating pork or handling raw pork. Usually, if you prepare or cook your pork/meat product above temperature 70C (160F) the temperature could kill most of the germs and viruses, including h1n1 virus

Swine Flu Vs. Bird Flu: Which Is The Greater Pandemic Threat? New Research Hints At Why Swine Flu Overshadows Bird Flu In Pandemic Potential, Chiehwen Ed Hsu

Chiehwen Ed Hsu

Ed Hsu, associate professor of public health informatics at the University of Texas School of Health Information Sciences and School of Public Health, agreed. "This study renders potential explanations for why Avian Flu virus does not effectively transmit from human to human -- an important indicator for raising pandemic level." Take, for example, the virulence of bird flu. Despite the relative paucity of human cases of bird flu among humans, Hsu said, 258 people have died since 2003 as a result of the bird flu virus -- a case fatality rate of more than 60 percent. "Once [bird flu] viruses …

2 Billion Infected? Who Stokes Swine Flu Fear, Chiehwen Ed Hsu

Chiehwen Ed Hsu

One could reasonably question the reliability of WHO's statement of mass infection," he said. "By making such statement without strong backing WHO may risk putting its accountability on the line. "I think that WHO could serve the world health better by providing a more evidence-based, sensible 'benchmark' of H1N1 infection," said Ed Hsu, associate professor of public health informatics at the University of Texas School of Health Information Sciences and School of Public Health. He argued that the 2 billion figure, based on past pandemics, does not take into account recent public health improvements. Moreover, his own research has suggested …

Swine Flu Likely To Return To U.S. Next Winter - Experts Can't Predict Whether It Will Be More Virulent Or Not, Chiehwen Ed Hsu

Chiehwen Ed Hsu

explained C. Ed Hsu, an associate professor of public health informatics at the University of Texas School of Health Information Sciences at Houston and associate director of health informatics at the Center for Biosecurity and Public Health Preparedness at the University of Texas School of Public Health. "How and when the flu spreads is dependent on other factors as well: the fitness and efficiency of the virus itself along with its innate ability to replicate; the susceptibility of the host; and the environment, which includes not only the weather, but also human behavior (for example, groups of people confined together …

Physical Activity And Neurocognitive Function Across The Lifespan, Jason Themanson, Charles Hillman, Sarah Buck

Jason R. Themanson, Ph.D

No abstract provided.

How Experience Confronts Ethics, Barry Hoffmaster, Cliff Hooker

C. Barry Hoffmaster

Analytic moral philosophy's strong divide between empirical and normative restricts facts to providing information for the application of norms and does not allow them to confront or challenge norms. So any genuine attempt to incorporate experience and empirical research into bioethics--to give the empirical more than the status of mere 'descriptive ethics'--must make a sharp break with the kind of analytic moral philosophy that has dominated contemporary bioethics. Examples from bioethics and science are used to illustrate the problems with the method of application that philosophically prevails in both domains and with the conception of rationality that underlies this method. …

Flu Experts Debate Potential Number Of H1n1 Infections Worldwide, Chiehwen Ed Hsu

Chiehwen Ed Hsu

According to ABC News. "I think that WHO could serve the world health better by providing a more evidence-based, sensible 'benchmark' of H1N1 infection," said Ed Hsu, associate professor of public health informatics at the University of Texas School of Health Information Sciences and School of Public Health. Hsu said that while the WHO's estimates are grounded in historic data, they fail to consider improvement in public health, and his research shows signs that the numbers of swine flu infections in the U.S. are stabilizing. "One could reasonably question the reliability of WHO's statement of mass infection," Hsu said. "By …